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胃肠结核:一项基于尸检的研究。

Gastrointestinal tuberculosis: An autopsy-based study.

作者信息

Mantilla Julio Cesar, Chaves Juan José, Africano-Lopez Ferney, Blanco-Barrera Néstor, Mantilla Marta Juliana

机构信息

Department of Pathology, Universidad Industrial de Santander, Bucaramanga 680002, Colombia.

Department of Pathology, Hospital Universitario de Santander, Bucaramanga 680002, Colombia.

出版信息

Infect Med (Beijing). 2023 May 1;2(2):122-127. doi: 10.1016/j.imj.2023.04.007. eCollection 2023 Jun.

Abstract

BACKGROUND

Tuberculosis is a disease of great relevance since it is one of the leading causes of morbidity and mortality worldwide. Gastrointestinal tuberculosis is an unusual presentation. It is defined as the involvement of any segment of the digestive tract, associated viscera, and peritoneum. The study's main objective is to collect information from autopsies of patients diagnosed with gastrointestinal tuberculosis in a Pathology reference center in Colombia.

METHODS

This is a retrospective and descriptive study of autopsy reports. A total of 4,500 autopsies were performed between January 2004 and December 2020. The inclusion criteria were authorization of a family member following local law regulations and a final autopsy diagnosis of gastrointestinal tuberculosis using microscopic visualization.

RESULTS

Forty-eight patients with gastrointestinal tuberculosis autopsies were included in our study. Most of the patients were male ( = 35, 72.9%) with a median age of 40.5 years old. Human immunodeficiency virus infection history was reported in 28 cases (58.33%). The most affected gastrointestinal tract site was the terminal ileum. Ulcers and thickened epithelium were common autopsies macroscopic findings. Tuberculosis multiorgan compromise was a relevant finding in patients with gastrointestinal tuberculosis.

CONCLUSIONS

Gastrointestinal tuberculosis is a disease of great importance, being its diagnosis a clinical challenge. Underdiagnosis can be reported in a high percentage of cases, so autopsy diagnosis can help reveal more accurate data about this condition.

摘要

背景

结核病是一种具有重大意义的疾病,因为它是全球发病和死亡的主要原因之一。胃肠道结核是一种不常见的表现形式。它被定义为消化道的任何节段、相关内脏和腹膜受累。该研究的主要目的是从哥伦比亚一家病理学参考中心对诊断为胃肠道结核的患者进行的尸检中收集信息。

方法

这是一项对尸检报告的回顾性描述性研究。2004年1月至2020年12月期间共进行了4500例尸检。纳入标准是根据当地法律法规获得家庭成员的授权,以及使用显微镜观察最终尸检诊断为胃肠道结核。

结果

我们的研究纳入了48例进行了胃肠道结核尸检的患者。大多数患者为男性(n = 35,72.9%),中位年龄为40.5岁。28例(58.33%)报告有人类免疫缺陷病毒感染史。胃肠道最常受累的部位是回肠末端。溃疡和上皮增厚是常见的尸检宏观发现。结核多器官损害是胃肠道结核患者的一个相关发现。

结论

胃肠道结核是一种非常重要的疾病,其诊断是一项临床挑战。在高比例的病例中可能存在漏诊,因此尸检诊断有助于揭示有关这种疾病的更准确数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a931/10699657/0c6200a2e37a/ga1.jpg

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